|Table of Contents|

Prognostic value of fibrinogen combined with neutrophil-lymphocyte ratio in patients with nasopharyngeal carcinoma undergoing intensity-modulated radiation therapy before treatment

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 09
Page:
1646-1653
Research Field:
Publishing date:

Info

Title:
Prognostic value of fibrinogen combined with neutrophil-lymphocyte ratio in patients with nasopharyngeal carcinoma undergoing intensity-modulated radiation therapy before treatment
Author(s):
WANG Yingyi1; DANG Qianqian1; DENG Xiaoyu1; CHEN Linhui1; LI Bingyan1; LI Huizhen2; ZHOU Pengcheng1; LIANG Tiansong1; 2; ZHENG Yingjuan1; 2; YANG Daoke1; 2
1.Radiotherapy Department,the First Affiliated Hospital of Zhengzhou University,Henan Zhengzhou 450000,China;2.Institute of Radiation Therapy and Oncology Emergency Critical Care，Zhengzhou University,Henan Zhengzhou 450000,China.
Keywords:
nasopharyngeal carcinoma; fibrinogen; neutrophil-lymphocyte ratio; prognosis
PACS:
R739.63
DOI:
10.3969/j.issn.1672-4992.2023.09.012
Abstract:
Objective: To investigate the prognostic value of fibrinogen (Fib) combined with neutrophil-lymphocyte ratio (NLR) index (F-NLR score) before intensity-modulated radiation therapy (IMRT) in patients with nasopharyngeal carcinoma (NPC).Methods:The clinical data of NPC patients who received IMRT between January 2016 and December 2018 were retrospectively analyzed.The optimal cut-off values of Fib and NLR were calculated according to the receiver operating characteristic curve,after which the patients were grouped.Differences in clinical characteristics and the short-term efficacy of treatment between the groups were analyzed using χ2 or Fisher's exact tests.Univariate and multivariate survival analyses were performed using the Cox proportional hazards model to identify the risk factors affecting prognosis.The survival curves were drawn by the Kaplan-Meier method,and Log-rank tests were used to compare the differences between the survival curves of each group.P<0.05 was considered statistically significant.Results:The optimal cut-off values of Fib and NLR were 3.455 g/L and 2.99,respectively.Significant differences were found for alcohol consumption and T stage between the F-NLR groups.There were also significant differences in the short-term efficacy of treatment in the different Fib,NLR,and F-NLR groups.Multivariate analysis showed that the F-NLR score,TNM stage,and EBV DNA copy number were independent risk factors for overall survival in NPC patients and both overall and progression-free survival differed significantly between the different F-NLR groups (P<0.001).Conclusion:High F-NLR score before treatment is an independent risk factor for poor prognosis in NPC patients receiving IMRT,and the combination of TNM stage and EBV DNA copy number can more accurately predict the prognosis of NPC patients.

References:

［1］SUNG H,FERLAY J,SIEGEL RL,et al.Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries ［J］.CA:A Cancer Journal for Clinicians,2021,71(3):209-249.
［2］CHEN YP,CHAN ATC,LE QT,et al.Nasopharyngeal carcinoma ［J］.Lancet,2019,394(10192):64-80.
［3］SUN X,SU S,CHEN C,et al.Long-term outcomes of intensity-modulated radiotherapy for 868 patients with nasopharyngeal carcinoma:an analysis of survival and treatment toxicities ［J］.Radiother Oncol,2014,110(3):398-403.
［4］SENGA SS,GROSE RP.Hallmarks of cancer-the new testament ［J］.Open Biology,2021,11(1):200358.
［5］PUNJABI A,BARRETT E,CHENG A,et al.Neutrophil-lymphocyte ratio and absolute lymphocyte count as prognostic markers in patients treated with curative-intent radiotherapy for non-small cell lung cancer ［J］.Clin Oncol (R Coll Radiol),2021,33(8):e331-e338.
［6］CHO Y,KIM JW,YOON HI,et al.The prognostic significance of neutrophil-to-lymphocyte ratio in head and neck cancer patients treated with radiotherapy ［J］.Journal of Clinical Medicine,2018,7(12):512.
［7］陈慧，郭俊清，马文娟，等.血液学指标对鼻咽癌患者预后意义的系统评价［J］.现代肿瘤医学,2020,28(15):2602-2609. CHEN H,GUO JQ,MA WJ,et al.Prognostic significance of hematological markers for patients with nasopharyngeal carcinoma:A Meta-amalysis［J］.Modern Oncology,2020,28(15):2602-2609.
［8］李玉梅.血浆纤维蛋白原水平与乳腺癌新辅助化疗疗效及预后的相关性［J］.现代肿瘤医学,2020,28(21):3722-3725. LI YM.Correlation between plasma fibrinogen level and the efficacy and prognosis of neoadjuvant chemotherapy for breast cancer［J］.Modern Oncology,2020,28(21):3722-3725.
［9］YAMAMOTO M,KUROKAWA Y,KOBAYASHI N,et al.Prognostic value of the combined index of plasma fibrinogen and the neutrophil-lymphocyte ratio in gastric cancer ［J］.World Journal of Surgery,2020,44(1):207-212.
［10］WANG H,ZHAO J,ZHANG M,et al.The combination of plasma fibrinogen and neutrophil lymphocyte ratio (F-NLR) is a predictive factor in patients with resectable non small cell lung cancer ［J］.Journal of Cellular Physiology,2018,233(5):4216-4224.
［11］冯梅，范子煊，黎杰，等.582例鼻咽癌调强放疗5年远期疗效及预后分析［J］.中华放射肿瘤学杂志，2011,20(05):369-373. FENG M,FAN ZX,LI J,et al.Long-term results and prognostic factors in 582 nasopharyngeal carcinoma treated by intensitymodulated radiotherapy［J］.Chinese Journal of Radiation Oncology,2011,20(05):369-373.
［12］ANTONIO N,BNNELYKKE-BEHRNDTZ ML,WARD LC,et al.The wound inflammatory response exacerbates growth of pre-neoplastic cells and progression to cancer ［J］.The EMBO Journal,2015,34(17):2219-2236.
［13］OCANA A,NIETO-JIMNEZ C,PANDIELLA A,et al.Neutrophils in cancer:prognostic role and therapeutic strategies ［J］.Molecular Cancer,2017,16(1):137.
［14］TECCHIO C,SCAPINI P,PIZZOLO G,et al.On the cytokines produced by human neutrophils in tumors ［J］.Seminars in Cancer Biology,2013,23(3):159-170.
［15］CHEN L,LI M,XU T,et al.Prognostic value of neutrophils for patients with nasopharyngeal carcinoma ［J］.Laryngoscope Investigative Otolaryngology,2021,6(2):219-225.
［16］陈智丹，张远起.中性粒细胞与淋巴细胞比值对恶性肿瘤预后的影响［J］.医学信息,2021,34(08):57-59. CHEN ZD,ZHANG YQ.The influence of the ratio of neutrophils to lymphocytes on the prognosis of malignant tumors［J］.Journal of Medical Information,2021,34(08):57-59.
［17］吴桐,张华.中性粒细胞与淋巴细胞比值和鼻咽癌预后的相关性研究进展［J］.中国眼耳鼻喉科杂志,2020,20(02):140-142. WU T，ZHANG H.Progress on the correlationship between the ratio of neutrophils to lymphocytes and the prognosis of nasopharyngeal carcinoma［J］.Chin J Ophthalmol and Otorhinolaryngol,2020,20(02):140-142.
［18］李晓惠，徐冰清，高劲，等.中性粒细胞与淋巴细胞比值对鼻咽癌放射敏感性及预后影响的研究［J］.中华放射肿瘤学杂志，2016，25(05):432-436. LI XH,XU BQ,GAO J,et al.Influence of neutrophil-lymphocyte ratio on radiosensitivity and prognosis in patients with nasopharyngeal carcinoma［J］.Chinese Journal of Radiation Oncology,2016,25(05):432-436.
［19］SUN ZQ,HAN XN,WANG HJ,et al.Prognostic significance of preoperative fibrinogen in patients with colon cancer ［J］.World J Gastroenterol,2014,20(26):8583-8591.
［20］HE SS,WANG Y,YANG L,et al.Plasma fibrinogen correlates with metastasis and is associated with prognosis in human nasopharyngeal carcinoma ［J］.Journal of Cancer,2017,8(3):403-409.
［21］ARIGAMI T,OKUMURA H,MATSUMOTO M,et al.Analysis of the fibrinogen and neutrophil-lymphocyte ratio in esophageal squamous cell carcinoma:a promising blood marker of tumor progression and prognosis ［J］.Medicine (Baltimore),2015,94(42):e1702.
［22］QU H,HUANG Y,ZHAO S,et al.Prognostic value of Epstein-Barr virus DNA level for nasopharyngeal carcinoma:a meta-analysis of 8128 cases ［J］.European Archives of Oto-rhino-laryngology,2020,277(1):9-18.
［23］CHANG H,GAO J,XU BQ,et al.Haemoglobin,neutrophil to lymphocyte ratio and platelet count improve prognosis prediction of the TNM staging system in nasopharyngeal carcinoma:development and validation in 3,237 patients from a single institution ［J］.Clin Oncol (R Coll Radiol),2013,25(11):639-646.
［24］LI X,CHANG H,TAO Y,et al.Revalidation of a prognostic score model based on complete blood count for nasopharyngeal carcinoma through a prospective study ［J］.Chinese Journal of Cancer Research,2016,28(5):467-477.
［25］HUI L,CHEN Y.Tumor microenvironment:Sanctuary of the devil ［J］.Cancer Lett,2015,368(1):7-13.
［26］OU D,WANG X,WU M,et al.Prognostic value of post-radiotherapy neutrophil-to-lymphocyte ratio in locally advanced nasopharyngeal carcinoma ［J］.Strahlenther Onkol,2020,196(3):252-261.

Memo

Memo:
河南省医学科技攻关计划联合共建项目（编号：LHGJ20190046）
Last Update: 2023-03-30